Medication Side Effects: Addressing Sexual Dysfunction and Memory Issues

Unsure if it is a side effect of the medication?

Hello, doctor.
I am currently taking psychiatric medications, specifically Fluphenazine and Risperidone.
Previously, I was also taking Benztropine to alleviate the muscle stiffness side effects of Risperidone, but I stopped Benztropine due to experiencing physical weakness.
I have reduced my Risperidone dosage to half a tablet.

What concerns me now is my lack of sexual interest; I don't feel pleasure even during DIY activities.
I believe this issue started when I switched to these two medications.
However, my doctor told me that these medications should not cause a decrease in libido and advised me not to overthink it.
Yet, my feelings are quite evident.
Additionally, I feel like my memory has declined; I easily forget things I just said and struggle to recall many other things.
I'm not sure if this is related to my previous use of Duloxetine and Escitalopram.
The reason I plan to revisit the psychiatrist is that I find myself fixating on thoughts about a girl I like, which leads to compulsive thinking and anxiety.
I used to feel fearful in crowds, but now the compulsive thoughts have diminished, and I no longer feel afraid when walking in a department store among people.
What should I do now? Should I consider consulting a different specialty?

Cang Zhilang, 30~39 year old female. Ask Date: 2023/06/20

Dr. Qiu Junda reply Psychiatry

Hello.
The causes of decreased libido are quite complex.
Factors such as emotions, stress, and medications (side effects) can all play a role.
The two medications you mentioned do indeed have limited mention of such side effects in their prescribing information.
Since you have stopped taking the medication, you can observe your condition for a while longer.
During this time, you may also consider consulting a urologist to evaluate issues related to decreased libido, which may help in improving the situation.

Reply Date: 2023/06/20

More Info

When it comes to understanding the side effects of psychiatric medications, particularly in relation to sexual dysfunction and memory issues, it’s crucial to consider both the medications you are taking and the underlying conditions they are meant to treat.
From your description, it appears you are currently taking medications such as Clonazepam (often used for anxiety and panic disorders) and possibly others like Escitalopram (an antidepressant) and Aripiprazole (an antipsychotic). Each of these medications can have varying effects on sexual function and cognitive abilities, including memory.

Sexual Dysfunction:
Sexual dysfunction is a common side effect associated with many psychiatric medications. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) like Escitalopram, are well-known for potentially causing decreased libido, delayed ejaculation, or anorgasmia (difficulty achieving orgasm). Clonazepam, being a benzodiazepine, can also contribute to sexual dysfunction, although it is less commonly reported.
It’s important to communicate openly with your healthcare provider about these concerns. While your doctor may believe that the medications you are taking do not cause sexual side effects, your personal experience is valid and should be taken seriously. There may be alternative medications or adjunct therapies that could alleviate these side effects without compromising your mental health treatment.

Memory Issues:
Regarding memory problems, benzodiazepines like Clonazepam can lead to cognitive impairment, especially with long-term use. This includes difficulties with memory, attention, and overall cognitive function. The effects can be more pronounced in individuals who have been on these medications for extended periods.
Antidepressants and antipsychotics can also affect cognitive function, but the extent varies widely among individuals. It’s worth noting that the underlying mental health conditions themselves, such as anxiety or depression, can also contribute to cognitive difficulties.
If you are experiencing significant memory issues, it may be beneficial to discuss this with your psychiatrist. They might consider adjusting your medication regimen or exploring cognitive behavioral therapy (CBT) or other therapeutic options that can help improve cognitive function.

Next Steps:
1. Consult Your Psychiatrist: Schedule an appointment to discuss your concerns about sexual dysfunction and memory issues. Be specific about your experiences and how they affect your daily life.

2. Consider Medication Review: Ask your psychiatrist if a review of your current medications is warranted. There may be alternatives that are less likely to cause these side effects.

3. Therapeutic Options: Inquire about non-pharmacological treatments that could help with both sexual dysfunction and cognitive issues, such as therapy or lifestyle changes (e.g., exercise, diet, sleep hygiene).

4. Monitor Symptoms: Keep a journal of your symptoms, noting when they occur and any potential triggers. This information can be invaluable for your healthcare provider in tailoring your treatment plan.

5. Explore Support Groups: Sometimes, talking to others who are experiencing similar issues can provide comfort and practical advice.

In conclusion, while psychiatric medications can be essential for managing mental health conditions, they can also lead to side effects that significantly impact quality of life. Open communication with your healthcare provider is key to finding a balance that allows you to manage your mental health effectively while minimizing unwanted side effects.

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